Lori Posted Wed 26th of December, 2012 21:00:29 PM
We had submitted a claim for a patient who was seen for her 2 month visit. We had submitted CPT code
99391 with a diagnosis pointer to the primary ICD-9 code
V20.2. An ICD-9 code
652.20 was submiited but NOT as a diagnosis pointer to the visit. The claim was denied because for an invalid/missing diagnosis code. We called the insurance company who informed us that the ICD-9 code
652.20 was not age appropriate for the patient;
652.20 is to be used for 12 years to 55 years of age. We checked the ICD-9 coding book but it does not specify this information. Please verify and advise us on this information.
We thank you for your input.
SuperCoder Answered Thu 03rd of January, 2013 21:02:44 PM
We are working on this and get back to you soon. We apologize for the delay.
SuperCoder Answered Fri 04th of January, 2013 17:07:47 PM
I don't see anything in ICD-9 about age requirements for 652.20 either, please check if this question might have a typo .
Code 652.20 is a labor/delivery code -- breech presentation without mention of version. If the mom is bringing her 2-month-old baby for a well check, I'm not sure how a breech presentation code would apply. Could you please clarify that this is the correct diagnosis?